Myths About Your Health Benefits

Signed into law by President Barack Obama in 2010, the Affordable Care Act revolutionized health care in America, and the country is still digesting the big changes. Part of the process is debunking once and for all, the many myths and misunderstandings about the law, its effect on health care benefits, and about medical insurance in general. Here are four myths to lay to rest today.

All Doctors and Hospitals Accept Your Plan

The federal government passed the Affordable Care Act, and the state exchanges sell health insurance plans under it. Because of this joint federal-state involvement, some people think the plans they purchase from the exchanges are government plans, which all doctors and medical facilities must accept.

"This is not true," says Sacramento resident Ellen Barnette, who works with the Covered California health exchange. "The myth is particularly dangerous," she says, "because it might prevent members of the public from doing the research they need to do before selecting a plan."

Take the time to find a plan that includes your preferred doctors and hospitals. Usually your health care exchange will help if you call with questions.

ACA Health Coverage Is Not Affordable

Affordable Care Act health coverage is low-cost for people without employer-provided coverage. If you get health insurance through your job, you don't have to worry about buying it through the marketplace. But, if you don't get health benefits at work, the ACA provides financial assistance to lower the cost of health insurance to low-income people.

Eighty percent of people who purchase insurance in the marketplace qualify for financial assistance, such as tax credits and subsidies. The ACA also reduces the cost to you by limiting a patient's out-of-pocket spending.

Health Insurance Is a Waste of Money

In America, health care is a private business, so doctors and clinics can charge whatever they like. Health insurance companies negotiate deep discounts for people insured with them. You may not realize that if you go to the doctor and pay out-of-pocket, the bill you get is a lot higher than the bill your insurance company would receive if you were covered under their policy.

The difference between retail rates and the insurer-negotiated rates is significant. Even if you carry minimal coverage and plan to pay most medical expenses yourself, doctors must charge you — as an insured patient — the lower rates for care. If you find yourself in the emergency room, the difference between what you pay and what you would have paid without insurance could easily far exceed the amount you pay for a year's insurance premiums.

The ACA Eliminates Good, Cheap Insurance Plans

Before the Affordable Care Act was passed, federal law did not require that a health care plan provide a set, minimum level of coverage. Because of this, you could find "cheap" health coverage that seemed like a bargain. But when you became ill, the plans didn't seem much like a bargain — they paid only a small part of the treatment costs, leaving you to pick up the rest. This forced people into debt or into bankruptcy. The ACA requires that health plans provide certain coverage, and while you may pay more, you get coverage you can count on.

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